The Bockser is one of the list of frail elderly people in Massachusetts, who urgently need help in eating, bathing and cleaning, but are suddenly locked out of qualified aid due to a big hole in the state's budget. Healey Administration concluded its registration for the Enhanced Community Options program. It is a fully state-funded service that provides seniors at risk of ending in nursing homes with 7.5 hours of home care support each week.
The community nonprofit that helps Elder register is ordered to reduce the number of people who receive the service from over 9,000 to 7,322 by the end of June.
The program is one of five home-based services for medium-income individuals and managed by five states.
The state will not be cut by anyone in the program, but those who wish to register for new state support must be on the waiting list until the number of people receiving services decreases by more than 1,800.
“These are blue-collar workers, teachers, working for the rest of their lives, need help to stay home now, and while they're not poor, they don't have the costly resources to pay for home services,” said Lisa Gurgone, chief executive officer of Mystic Valley Elder Services, a nonprofit that helps older adults and disabled adults live independently.
Nonprofit staff have helped the Bockser register for another state-funded home care program, which only provides home aides for about two hours a week to help with cleaning and laundry. In other words, Bocker relies on the kindness of his neighbors to help her bathe, shop, and run other errands.
The combination of factors contributes to heartburn in state managers' budget plans, including threatened cuts in Medicaid funding by the Trump administration. This federal state pool is paid for many of the state's many elder services, including two other home care programs for low-income individuals.
“I think the financial reality is that we are really trying to set ourselves up so that we can maintain our current services,” said Lynn Widler, secretary to the state's Aging and Independence Enforcement Office.
Vidler said the state cuts are likely to last for the new fiscal year that begins in July.
“We're really considering… make sure we're making sure we're a good steward of taxpayer dollars (FY26) financial climate and that we're going to be good custodians of taxpayers dollars,” she said.
At the same time, Massachusetts is working with rising seniors, with over 70 of them among the fastest growing parts of the state's population. And many people want to age in their homes.
Gov. Maura Healy recently asked state legislators to step up some drooping elder services by June. But simply inserting a financial hole into a popular, enhanced community option home care programme is not enough. The service is open to adults who often end up in nursing homes. This is primarily those over the age of 60 who have experienced a medical crisis or recent decline, earning less than $35,601 per adult annually. The program accounts for about 13% of the total 71,000 elders who received some form of state or Medicaid-funded housing support last year.
The state's decision to significantly curb new enrollment in the enhanced optional home care programme comes at a time of curiosity, proponents say. They pointed to the state agreement last year, spending $1 billion over eight years, with thousands moving out of nursing homes and returning to the community with support.
But now that demanding home elders wait for home care will inevitably develop many health issues and fall into nursing homes, Betsy Rimins, executive director of Massaging Access, an association of nonprofits that support adults and people with disabilities, said they will remain independent in the community.
“This is to close your face tightly so that you stay as you,” she said.
The state “someone will pay it three times with a Medicaid program that will have worse outcomes,” Crimins added.
A nationally designated nonprofit organization that registers elders for home care is rushing for workarounds.
“We have someone shower once a week waiting for someone to get there,” said Lisa Jimenez, a nurse who directs clinical services at Mystic Valley Elder Services.
“We're now getting people at risk of skin breakdowns and infections,” she said. “I want to catch it before it gets an ulcer.”
The story is taken from senior service from a nonprofit organization in disastrous circumstances.
In the 90s, there was a man reading his 91-year-old wife and trying to take care of him in a condo. She has Alzheimer's disease and macular degeneration and was recently hospitalized with pneumonia. They are on the waiting list, but in between they are eligible for two hours of weekly home care.
And the 71-year-old woman tied to a bed with uterine cancer, tired of the benefits of Medicare and trying to take care of her, but is completely dependent on her sister, who is quickly overwhelmed by bathing, dressing, toilets, incontinence, drug management, grocery shopping, laundry, meal preparation and cleaning.
“To fill these gaps there will be more stress on family caregivers and pressures will put hospitals and other facilities to think outside the box for discharge plans.
Back in Libya, Bokser, 93, waiting for more help, said the doctors couldn't understand why she lost her lighthead and her lighthead last September, leading to that troublesome fall. She is worried without further assistance, she may collapse again.
“It always feels like a sword hanging over me, and it can happen anytime,” she said. “I'm just trying to stay here and see how long it can last.”
Kay Lazar can be followed by @globekaylazar at kay.lazar@globe.com.
